Table of Contents:

Foreword

Introduction

I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chickenís Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Donít Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse

Topics

References 1-3,199

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If despite our best precautions we fell ill, how could we take care of ourselves at home if the health care system broke down? The most important thing may be to start antivirals as soon as possible after the first symptoms begin. By the time the pandemic strikes one’s area, the constellation of symptoms for the particular pandemic strain should be well known. Every news outlet will presumably be all pandemic, all the time.

Onset is sudden. The French call it la grippe, conjuring images of being seized by disease. People describe it as “like being hit with a truck.” The flu generally strikes with sudden fever and chills, cough, muscle aches, fatigue, and weakness such that it’s hard to get out of bed. The flu is hard to miss.

Although high fever in children for any reason can cause them to vomit, gastrointestinal symptoms are rare with influenza.2717 The so-called 24- or 48-hour “stomach flu,” with nausea, vomiting, and diarrhea, is an unfortunate misnomer. As mentioned in chapter 9, the “24-hour flu” is most often a case of food poisoning (viral food-borne gastroenteritis), not influenza.2718

The common cold, in contrast to influenza, is more of a localized, sniffly-sneezy-sore-throat-stuffy-nose phenomenon, lacking the systemic flu symptoms of extreme fatigue, fever, and severe aches and pains. Cough, headache, and chest discomfort can accompany either, but tend to be more severe in influenza.2719

With or without antivirals, the foundation of treatment becomes rest and fluids. Fatigue, weakness, and muscle aches are your body’s way of telling you to stay in bed. Your body is no dummy. Not only will you be less likely to spread the disease to others, but bed rest lets your body proportion more energy to mobilize initial defenses.2720 Avoiding exertion also reduces the likelihood of gasping virus further into the lungs with deep inhalation.2721 In fact, one guess as to why more young men than young women died in 1918 “may be due to the tendency of many men, out of necessity or masculine impulse, to continue working rather than resting when they were sick.”2722

Next to antivirals, the best thing one can typically do to survive the flu is to keep properly hydrated by sipping at least one cup of water, tea, juice, soup, or other nonalcoholic beverage every waking hour. That’s two to four quarts of liquid a day, which loosens pulmonary secretions to help rid the body of the virus2723 and prevent the dehydration that accompanies fever.2724 If you or the person you are nursing isn’t eating, electrolytes can be added to the rehydration solution.
Recipe for Rehydration Solution
1 quart (or liter) drinking water
2 tablespoons of sugar
¼ teaspoon of table salt
¼ teaspoon of baking soda

Mix to make approximately one quart
If available, adding ¼ teaspoon of salt substitute (potassium chloride), ½ cup of orange juice or coconut water, or half of a large mashed ripe banana would add potassium. The solution can be flavored with lemon juice or a sugar-free powdered drink mix. If baking soda is unavailable, substitute another ¼ teaspoon of salt.2725 If a person is too sick to drink, fluid can be given literally drop by drop until the patient recovers.2726 Treating influenza outside of a medical setting is less a matter of feeding or starving a fever than it is of drowning it.

Fever reduction is a controversial subject. Fever may be uncomfortable, but it has a beneficial effect on the course of many infections. Elevated temperatures have been shown to inhibit influenza virus replication. Again, our body usually knows best.2727 Artificially breaking a fever with drugs like acetaminophen (Tylenol) or ibuprofen (Motrin) may make us feel better, but we may be undermining our body’s ability to fight. A cool cloth on the forehead can make us feel better without lowering our internal virus-fighting fever. Drugs should be considered, though, when the febrile discomfort or muscle aches interfere with sleep, which is also important for recovery. High fevers—over 104°F—should definitely be treated. A combination of acetaminophen and ibuprofen, both taken at the same time, and tepid-water sponge-baths should successfully bring down almost any high fever. Aspirin should never be given to a child because of the risk of a rare but serious side effect known as Reye’s syndrome.2728 Chicken soup might be out of the question during a bird flu pandemic, but warm liquids in general can relieve symptomatic congestion and may also beneficially raise the temperature of the respiratory passageways.2729

The lay press has touted the anti-viral benefits of a chemical compound found naturally in grapes called resveratrol.2730 In laboratory experiments performed on infected mice, injection with resveratrol did indeed seem to enhance survival,2731 but the researchers used massive doses in a non-oral route in nonhuman subjects.2732 The human equivalent would mean drinking four gallons of red wine’s worth of the compound daily.2733 So while resveratrol may hold some future pharmacological potential, grape juice may be no better than any other hydrating liquid. With or without Tamiflu, no combination of questionable remedies touted over the internet has been shown to trump bed rest and fluids to improve survival.